COMMITTEES

Senator ANANDA-RAJAH (Victoria) (17:09): I also rise to speak, as a member of the committee that is chaired by Senator O'Neill, in relation to the Delegated legislation monitor: monitor 4 of 2026 report, which refers to the landmark amendments that we've introduced regarding aged care. As you know, Acting Deputy President O'Sullivan, when we came to government in 2022, the aged-care system was on its knees.

It was a story of crisis and abuse—systemic abuse—and neglect. Indeed, the interim report of the royal commission in 2019 was titled Neglect, and it described the aged-care system as a shocking tale of neglect. We discovered that this system was failing families.

It was certainly failing older Australians. And it was failing a workforce—a workforce that was gutted, during COVID; demoralised; on its knees; exhausted; wrapped in PPE. Older Australians were separated from their families.

And, during that period of time, I was working in hospital, pretty much, in PPE, and also dealing with the aftermath of an aged-care system that was fundamentally broken. So, when we came to office in 2022, the first business of the day—actually, the first bill we passed—was an aged-care bill, such was the state of this system in crisis. The second bill was on climate change.

We adopted a rights based approach to aged care. The nation told us that older Australians didn't want more rules. They wanted rights.

They wanted to have their say. They wanted dignity. And they wanted to have their autonomy protected.

And that's what we attempted to do, with this power of work, in our first term of government. The new Aged Care Act was a complete overhaul of the system. It was co-designed with older Australians, with their families and with aged-care providers.

There were multiple town halls; there were multiple meetings; there was a lot of testimony. A lot of consideration and care was given towards crafting this new Aged Care Act. It finally went live on 1 November last year.

Sure, it has had a few teething problems in the interim, but we expect that. This is, after all, a once-in-a-generation landmark reform. At its heart is care.

We are returning care to the aged-care system. There are two messages to take from this. The first is that, loud and clear, Australians said to us that they want to remain at home.

And I saw this every day of my clinical practice, working in a major hospital. Most hospitals around the country are actually filled with older Australians, because they carry the burden of disease. In fact, 80 per cent of Australians over the age of 65 have one chronic disease.

About one in four older Australians over the age of 65 have three or more chronic diseases. So the burden of disease is very high in the elderly. Hence, I have always regarded the aged-care system and the healthcare system as parts of one ecosystem.

If one breaks down, you end up with ramping; you end up with bed block; you end up with a logjam in the hospital system. This was a daily occurrence when I turned up to work every morning. And it was terrible, because elderly people should not be in chaotic, busy emergency departments.

They should not be on trolleys in corridors. They should not have the indignity of someone like me having to examine them in a corridor, with other people walking around, with no privacy. That is a thing that older Australians neither want nor need.

So it is imperative that we invest in restoring confidence to the aged-care system, because it will have really important downstream effects on our hospital and clinical system. There's an economic imperative as well, because hospital care is, by far, the most expensive type of health care. You want to keep people out of hospital as much as possible—and I'll come to that later on.

A big part of the reforms was actually enabling older Australians to stay at home. We now have a program called Support at Home. This program involves an assessment, and there are some questions regarding the assessment because it does involve an automated system with a human making a determination at the end and discussing what kind of supports a person is entitled to.

My understanding is that that automated system was done in an evidence based way, with 20,000 people, and it was developed with a strong evidence base. That's not to say it's perfect, but it absolutely is grounded in evidence from a dataset of 20,000. Support at Home involves providing people with the means necessary to remain at home and to live a dignified life.

That may include equipment, it may include modifications and clinical care, such as wound care, for example, dressings care, care with colostomy bags, PEG feeding and so on and so forth. The Commonwealth has said we will cover the cost of clinical care, but for all other care a copayment is required. Having recently been on a parliamentary multipartisan delegation to Singapore and Japan, which are two superageing societies, I discovered that both of these countries also have copayment systems.

Aged care is not regarded as something that is free to anyone; a copayment is required in both of these advanced economies. We also have a copayment. In addition to providing Support at Home, we have released 83,000 home care packages, which are going out the door.

But that's not all we've done. With respect to who actually provides this care, that of course is skilled, trained professionals. That workforce, as I said, was on its knees when we first came to government, but we have put in a power of work, backed in with a lot of dollars to stabilise that workforce and uplift it again.

We have backed in the biggest increase in aged-care salaries that has ever been seen in Australia's history, such that a registered nurse now working in aged care is earning $28,000 more per year. That is a huge bump in pay, and it's absolutely deserved because these people do the kind of work that a lot of other Australians won't do. It's manual work in residential aged care.

It is not simple work. There's a lot of monitoring required and a lot of care needed. We have brought in mandatory requirements around care minutes and food quality.

This means that we need to have a trained workforce in order to provide that sort of care, to lift standards and to maintain them at a certain level. That has certainly been our wish and our goal. In order to ensure that we have a stable workforce in aged care, we have also strengthened the pipeline.

That has happened through free TAFE as well as Commonwealth paid pracs. Free TAFE has been a runaway success, and we have seen over 725,000 enrolments in free TAFE, and many of them have been in aged care and other care sector services. We've backed that in with a Commonwealth paid prac allowance, which is around $340 a week for those student nurses who wish to undertake their mandatory placement in clinical settings.

This is how we are strengthening the aged-care system. We are also paying close attention to the wider health system because older Australians have a burden of disease. We've invested in bulk-billing, Medicare urgent care clinics and cheaper medicines to make that difference so that we don't see continuous pressure in our hospitals.